Acta anaesthesiologica Sinica最新文献

Background: We compared the clinical efficacy and safety between 2 doses of 2.5 ml (18.75 mg) and 3 ml (22.5 mg) of 0.75% glucose free spinal ropivacaine in Chinese parturients undergoing Cesarean section.

Methods: In this randomized, open-label study, 40 parturients enrolled were divided into two groups: Group A received a 2.5 ml 0.75% ropivacaine as opposed to 3 ml in Group B. Sensory and motor blocks were assessed during and after surgery until complete recovery. Eight standard measurements were taken: time at onset of sensory block; maximum cephalic sensory spread; maximum number of blocked segments; time to maximum sensory block; duration of sensory block at L3; time at onset of complete motor block and duration until complete recovery. Vital signs and any adverse effects related to spinal anesthesia were also recorded.

Results: Five of the 6 variables showed no significant difference between groups A and B: onset time of sensory block at L3 was 1.8 +/- 6.7 min vs. 2.3 +/- 9.8 min; maximum cephalic spread was T3-4 (C3-T7) vs. T3 (C2-T8); maximum number of blocked segments was 20.7 +/- 3.5 vs. 20.2 +/- 3.4; time to maximum sensory block 15.4 +/- 5.5 min vs. 20.3 +/- 15.1 min; time for regression to L3 was 200.8 +/- 59.5 min vs. 215.0 +/- 37.6 min and time for complete recovery of motor block 208.5 +/- 55.5 min vs. 226.5 +/- 461. min. Group B had a significantly faster onset time for complete motor block (P < 0.05) 15.4 +/- 5.6 min vs. 10.4 +/- 4.7 min. Moreover, there were no significant differences in global hemodynamic changes during and after the operation. Transient hypotension attacks were more frequent in group A at the beginning of anesthesia, perhaps due to inadequate prehydration. Otherwise, there were no differences in adverse effects during or after surgery.

Conclusions: We conclude that for Cesarean section in Chinese parturients either 18.75 mg (2.5 ml) or 22.5 mg (3 ml) 0.75% glucose-free ropivacaine can provide a spinal anesthesia of the same efficacy and safety.

Background: This study was designed to examine the optimal timing of intravenous lidocaine in attenuation of increase of intraocular pressure in response to laryngoscopy and tracheal intubation during induction of anesthesia.

Methods: One hundred and thirty five adult patients of ASA class I, aged between 20-35 years, undergoing surgical procedures irrelevant to ophthalmology were enrolled for study. Patients were randomly assigned to one of five groups. In group II, III, IV and V the patients received intravenous injection of lidocaine (2 mg/kg), 1, 3, 5, 10 min before tracheal intubation, respectively. Group I in which patients did not receive lidocaine served as the control group.

Results: In patients of groups I, IV and V, the intraocular pressure increased significantly after intubation, whereas in those of groups II and III, the intraocular pressure did not. All patients in the five groups showed concomitantly a surge of blood pressure, but the magnitude of increase was smallest in group III in comparison with the other groups. The values of systolic and diastolic pressures 1 min after intubation were significantly less in groups III and IV than in the control group.

Conclusions: In healthy patients aged between 20 and 35 the most optimal time of administration of intravenous lidocaine to attenuate the increase of intraocular pressure seemed to be the space between 1 to 3 min before laryngoscopy and tracheal intubation.

Inferior vena cava tear is a rare but potentially lethal event associated with spinal surgery. Early recognition and repair are mandatory to minimize morbidity and mortality. Here we report a case of inferior vena cava tear which occurred during posterior spinal fusion surgery. Without marked bleeding from the surgical field, the patient was suddenly seized with a profound shock. Abdominal distension was found after resumption of the supine position from prone. Emergent exploratory laparotomy disclosed inferior vena cava tear. After repairing of the torn vessel, the patient was transferred to ICU. Unfortunately, patient expired two weeks later due to multiple-organ failure.